Choose Your Medicare Locality: ALABAMA ALASKA* ARIZONA ARKANSAS BAKERSFIELD CHICO EL CENTRO FRESNO HANFORD-CORCORAN LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) MADERA MERCED MODESTO NAPA OXNARD-THOUSAND OAKS-VENTURA REDDING RIVERSIDE-SAN BERNARDINO-ONTARIO SACRAMENTO-ROSEVILLE-FOLSOM SALINAS SAN DIEGO-CHULA VISTA-CARLSBAD SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) SAN LUIS OBISPO-PASO ROBLES SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) SANTA CRUZ-WATSONVILLE SANTA MARIA-SANTA BARBARA SANTA ROSA-PETALUMA STOCKTON VALLEJO VISALIA YUBA CITY REST OF CALIFORNIA COLORADO CONNECTICUT DC + MD/VA SUBURBS DELAWARE FORT LAUDERDALE MIAMI REST OF FLORIDA ATLANTA REST OF GEORGIA HAWAII, GUAM IDAHO CHICAGO EAST ST. LOUIS SUBURBAN CHICAGO REST OF ILLINOIS INDIANA IOWA KANSAS KENTUCKY NEW ORLEANS REST OF LOUISIANA SOUTHERN MAINE REST OF MAINE BALTIMORE/SURR. CNTYS REST OF MARYLAND METROPOLITAN BOSTON REST OF MASSACHUSETTS DETROIT REST OF MICHIGAN MINNESOTA MISSISSIPPI METROPOLITAN KANSAS CITY METROPOLITAN ST. LOUIS REST OF MISSOURI MONTANA** NEBRASKA NEVADA** NEW HAMPSHIRE NORTHERN NJ REST OF NEW JERSEY NEW MEXICO MANHATTAN NYC SUBURBS/LONG ISLAND POUGHKPSIE/N NYC SUBURBS QUEENS REST OF NEW YORK NORTH CAROLINA NORTH DAKOTA** OHIO OKLAHOMA PORTLAND REST OF OREGON METROPOLITAN PHILADELPHIA REST OF PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA** TENNESSEE AUSTIN BEAUMONT BRAZORIA DALLAS FORT WORTH GALVESTON HOUSTON REST OF TEXAS UTAH VERMONT VIRGINIA VIRGIN ISLANDS SEATTLE (KING CNTY) REST OF WASHINGTON WEST VIRGINIA WISCONSIN WYOMING**

Assistant involved in treatment: No Yes

Encounter Charges:

97161: PT Initial Eval (Low Complexity) ¹ 97162: PT Initial Eval (Moderate Complexity) ¹ 97163: PT Initial Eval (High Complexity) ¹ 97164: PT Re-Eval ¹ 97165: OT Initial Eval (Low Complexity) ¹ 97166: OT Initial Eval (Moderate Complexity) ¹ 97167: OT Initial Eval (High Complexity) ¹ 97168: OT Re-Eval ¹ 97110: Therapeutic Exercises 97140: Manual Therapy 97012: Mechanical Traction 97014: Electrical Stimulation (unattended) 97016: Vasopneumatic device 97018: Paraffin Bath 97022: Whirlpool 97024: Diathermy 97026: Infrared 97028: Ultraviolet 97032: Electrical Stimulation (manual) 97033: Iontophoresis 97034: Contrast Bath 97035: Ultrasound 97036: Hubbard Tank / Hydrotherapy 97039: Physical therapy treatment - unlisted 97112: Neuromuscular Re Education 97113: Aquatic Therapy/Exercises 97116: Gait Training 97150: Group Therapeutic Procedures 97129: Cognitive Function Intervenions, Initial 15 min 97130: Cognitive Function Intervenions, Additional 15 min 97530: Therapeutic Activities 97533: Sensory integration 97535: Self Care / Home Management Training 97537: Community / work reintegration training 97542: Wheelchair Management / Propulsion training 97550: Caregiver Training Without the Patient Present, Initial 30 Minutes 97551: Caregiver Training Without the Patient Present, Additional 15 Minures 97552: Group Caregiver Training Without the Patient Present 97760: Orthotic mgmt and training 97763: Orthotic/Prosthetic mgmt sbsq enc 97761: Prosthetic training 97755: Assistive technology assess G0283: Elec stim other than wound 95992: Canalith Repositioning 95907: Motor 1-2 nrv cndj test 95908: Motor 3-4 nrv cndj test 95909: Motor 5-6 nrv cndj test 95910: Motor 7-8 nrv cndj test 95911: Motor 9-10 nrv cndj test 95912: Motor 11-12 nrv cndj test 95913: Motor 13 nrv cndj test 97750: Physical performance test 96125: Standardized Cognitive Performance Testing 92523: Speech Sound + Language Comprehension Eval 92626: Eval of Auditory Rehab Status, 1st Hour 92611: Motion Fluoroscopy/Swallowing Eval 92597: Oral speech device eval 92521: Evaluation of speech fluency 92522: Evaluate speech production 92507: Speech/Language/Voice Tx, Individual 92508: Speech/Language/Voice Tx, Group 92524: Behavioral/Qualitative Analysis of Voice 92526: Oral function therapy 92610: Evaluate swallowing function 92607: AAC Exam/Rx, 1 Hour 92608: AAC Exam/Rx, Each Addl 30 min 92609: Use of speech device service 96105: Assessment of aphasia 98975: RTM Setup and Patient Education 98977: RTM Device Supply, MSK, 16+ days 98979: RTM Treatment Mgmt, First 10–19 min 98980: RTM Treatment Mgmt, First 20 min 98981: RTM Treatment Mgmt, Each Addl 20 min 98984: RTM Device Supply, Respiratory, 2–15 days 98985: RTM Device Supply, MSK, 2–15 days 90912: Biofeedback, Perineal Muscles, Initial 15 min 90913: Biofeedback, Perineal Muscles, Each Addl 15 min		Units   1 2 3 4 5 6
97161: PT Initial Eval (Low Complexity) ¹ 97162: PT Initial Eval (Moderate Complexity) ¹ 97163: PT Initial Eval (High Complexity) ¹ 97164: PT Re-Eval ¹ 97165: OT Initial Eval (Low Complexity) ¹ 97166: OT Initial Eval (Moderate Complexity) ¹ 97167: OT Initial Eval (High Complexity) ¹ 97168: OT Re-Eval ¹ 97110: Therapeutic Exercises 97140: Manual Therapy 97012: Mechanical Traction 97014: Electrical Stimulation (unattended) 97016: Vasopneumatic device 97018: Paraffin Bath 97022: Whirlpool 97024: Diathermy 97026: Infrared 97028: Ultraviolet 97032: Electrical Stimulation (manual) 97033: Iontophoresis 97034: Contrast Bath 97035: Ultrasound 97036: Hubbard Tank / Hydrotherapy 97039: Physical therapy treatment - unlisted 97112: Neuromuscular Re Education 97113: Aquatic Therapy/Exercises 97116: Gait Training 97150: Group Therapeutic Procedures 97129: Cognitive Function Intervenions, Initial 15 min 97130: Cognitive Function Intervenions, Additional 15 min 97530: Therapeutic Activities 97533: Sensory integration 97535: Self Care / Home Management Training 97537: Community / work reintegration training 97542: Wheelchair Management / Propulsion training 97550: Caregiver Training Without the Patient Present, Initial 30 Minutes 97551: Caregiver Training Without the Patient Present, Additional 15 Minures 97552: Group Caregiver Training Without the Patient Present 97760: Orthotic mgmt and training 97763: Orthotic/Prosthetic mgmt sbsq enc 97761: Prosthetic training 97755: Assistive technology assess G0283: Elec stim other than wound 95992: Canalith Repositioning 95907: Motor 1-2 nrv cndj test 95908: Motor 3-4 nrv cndj test 95909: Motor 5-6 nrv cndj test 95910: Motor 7-8 nrv cndj test 95911: Motor 9-10 nrv cndj test 95912: Motor 11-12 nrv cndj test 95913: Motor 13 nrv cndj test 97750: Physical performance test 96125: Standardized Cognitive Performance Testing 92523: Speech Sound + Language Comprehension Eval 92626: Eval of Auditory Rehab Status, 1st Hour 92611: Motion Fluoroscopy/Swallowing Eval 92597: Oral speech device eval 92521: Evaluation of speech fluency 92522: Evaluate speech production 92507: Speech/Language/Voice Tx, Individual 92508: Speech/Language/Voice Tx, Group 92524: Behavioral/Qualitative Analysis of Voice 92526: Oral function therapy 92610: Evaluate swallowing function 92607: AAC Exam/Rx, 1 Hour 92608: AAC Exam/Rx, Each Addl 30 min 92609: Use of speech device service 96105: Assessment of aphasia 98975: RTM Setup and Patient Education 98977: RTM Device Supply, MSK, 16+ days 98979: RTM Treatment Mgmt, First 10–19 min 98980: RTM Treatment Mgmt, First 20 min 98981: RTM Treatment Mgmt, Each Addl 20 min 98984: RTM Device Supply, Respiratory, 2–15 days 98985: RTM Device Supply, MSK, 2–15 days 90912: Biofeedback, Perineal Muscles, Initial 15 min 90913: Biofeedback, Perineal Muscles, Each Addl 15 min		Units   1 2 3 4 5 6
97161: PT Initial Eval (Low Complexity) ¹ 97162: PT Initial Eval (Moderate Complexity) ¹ 97163: PT Initial Eval (High Complexity) ¹ 97164: PT Re-Eval ¹ 97165: OT Initial Eval (Low Complexity) ¹ 97166: OT Initial Eval (Moderate Complexity) ¹ 97167: OT Initial Eval (High Complexity) ¹ 97168: OT Re-Eval ¹ 97110: Therapeutic Exercises 97140: Manual Therapy 97012: Mechanical Traction 97014: Electrical Stimulation (unattended) 97016: Vasopneumatic device 97018: Paraffin Bath 97022: Whirlpool 97024: Diathermy 97026: Infrared 97028: Ultraviolet 97032: Electrical Stimulation (manual) 97033: Iontophoresis 97034: Contrast Bath 97035: Ultrasound 97036: Hubbard Tank / Hydrotherapy 97039: Physical therapy treatment - unlisted 97112: Neuromuscular Re Education 97113: Aquatic Therapy/Exercises 97116: Gait Training 97150: Group Therapeutic Procedures 97129: Cognitive Function Intervenions, Initial 15 min 97130: Cognitive Function Intervenions, Additional 15 min 97530: Therapeutic Activities 97533: Sensory integration 97535: Self Care / Home Management Training 97537: Community / work reintegration training 97542: Wheelchair Management / Propulsion training 97550: Caregiver Training Without the Patient Present, Initial 30 Minutes 97551: Caregiver Training Without the Patient Present, Additional 15 Minures 97552: Group Caregiver Training Without the Patient Present 97760: Orthotic mgmt and training 97763: Orthotic/Prosthetic mgmt sbsq enc 97761: Prosthetic training 97755: Assistive technology assess G0283: Elec stim other than wound 95992: Canalith Repositioning 95907: Motor 1-2 nrv cndj test 95908: Motor 3-4 nrv cndj test 95909: Motor 5-6 nrv cndj test 95910: Motor 7-8 nrv cndj test 95911: Motor 9-10 nrv cndj test 95912: Motor 11-12 nrv cndj test 95913: Motor 13 nrv cndj test 97750: Physical performance test 96125: Standardized Cognitive Performance Testing 92523: Speech Sound + Language Comprehension Eval 92626: Eval of Auditory Rehab Status, 1st Hour 92611: Motion Fluoroscopy/Swallowing Eval 92597: Oral speech device eval 92521: Evaluation of speech fluency 92522: Evaluate speech production 92507: Speech/Language/Voice Tx, Individual 92508: Speech/Language/Voice Tx, Group 92524: Behavioral/Qualitative Analysis of Voice 92526: Oral function therapy 92610: Evaluate swallowing function 92607: AAC Exam/Rx, 1 Hour 92608: AAC Exam/Rx, Each Addl 30 min 92609: Use of speech device service 96105: Assessment of aphasia 98975: RTM Setup and Patient Education 98977: RTM Device Supply, MSK, 16+ days 98979: RTM Treatment Mgmt, First 10–19 min 98980: RTM Treatment Mgmt, First 20 min 98981: RTM Treatment Mgmt, Each Addl 20 min 98984: RTM Device Supply, Respiratory, 2–15 days 98985: RTM Device Supply, MSK, 2–15 days 90912: Biofeedback, Perineal Muscles, Initial 15 min 90913: Biofeedback, Perineal Muscles, Each Addl 15 min		Units   1 2 3 4 5 6
97161: PT Initial Eval (Low Complexity) ¹ 97162: PT Initial Eval (Moderate Complexity) ¹ 97163: PT Initial Eval (High Complexity) ¹ 97164: PT Re-Eval ¹ 97165: OT Initial Eval (Low Complexity) ¹ 97166: OT Initial Eval (Moderate Complexity) ¹ 97167: OT Initial Eval (High Complexity) ¹ 97168: OT Re-Eval ¹ 97110: Therapeutic Exercises 97140: Manual Therapy 97012: Mechanical Traction 97014: Electrical Stimulation (unattended) 97016: Vasopneumatic device 97018: Paraffin Bath 97022: Whirlpool 97024: Diathermy 97026: Infrared 97028: Ultraviolet 97032: Electrical Stimulation (manual) 97033: Iontophoresis 97034: Contrast Bath 97035: Ultrasound 97036: Hubbard Tank / Hydrotherapy 97039: Physical therapy treatment - unlisted 97112: Neuromuscular Re Education 97113: Aquatic Therapy/Exercises 97116: Gait Training 97150: Group Therapeutic Procedures 97129: Cognitive Function Intervenions, Initial 15 min 97130: Cognitive Function Intervenions, Additional 15 min 97530: Therapeutic Activities 97533: Sensory integration 97535: Self Care / Home Management Training 97537: Community / work reintegration training 97542: Wheelchair Management / Propulsion training 97550: Caregiver Training Without the Patient Present, Initial 30 Minutes 97551: Caregiver Training Without the Patient Present, Additional 15 Minures 97552: Group Caregiver Training Without the Patient Present 97760: Orthotic mgmt and training 97763: Orthotic/Prosthetic mgmt sbsq enc 97761: Prosthetic training 97755: Assistive technology assess G0283: Elec stim other than wound 95992: Canalith Repositioning 95907: Motor 1-2 nrv cndj test 95908: Motor 3-4 nrv cndj test 95909: Motor 5-6 nrv cndj test 95910: Motor 7-8 nrv cndj test 95911: Motor 9-10 nrv cndj test 95912: Motor 11-12 nrv cndj test 95913: Motor 13 nrv cndj test 97750: Physical performance test 96125: Standardized Cognitive Performance Testing 92523: Speech Sound + Language Comprehension Eval 92626: Eval of Auditory Rehab Status, 1st Hour 92611: Motion Fluoroscopy/Swallowing Eval 92597: Oral speech device eval 92521: Evaluation of speech fluency 92522: Evaluate speech production 92507: Speech/Language/Voice Tx, Individual 92508: Speech/Language/Voice Tx, Group 92524: Behavioral/Qualitative Analysis of Voice 92526: Oral function therapy 92610: Evaluate swallowing function 92607: AAC Exam/Rx, 1 Hour 92608: AAC Exam/Rx, Each Addl 30 min 92609: Use of speech device service 96105: Assessment of aphasia 98975: RTM Setup and Patient Education 98977: RTM Device Supply, MSK, 16+ days 98979: RTM Treatment Mgmt, First 10–19 min 98980: RTM Treatment Mgmt, First 20 min 98981: RTM Treatment Mgmt, Each Addl 20 min 98984: RTM Device Supply, Respiratory, 2–15 days 98985: RTM Device Supply, MSK, 2–15 days 90912: Biofeedback, Perineal Muscles, Initial 15 min 90913: Biofeedback, Perineal Muscles, Each Addl 15 min		Units   1 2 3 4 5 6